Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 15;17(5):3496-3504.
doi: 10.62347/PBLA2928. eCollection 2025.

Comparison of survival benefit and safety profile between lenvatinib and donafenib as conversion therapy in patients with hepatocellular carcinoma

Yuehong Hou  1 , Zhenlin Gao  1 , Yaguang Han  1 , Ci Liu  2 , Xiaojuan Su  3 , Dongliang Zhang  4
Affiliations

Comparison of survival benefit and safety profile between lenvatinib and donafenib as conversion therapy in patients with hepatocellular carcinoma

Yuehong Hou et al. Am J Transl Res. .

Abstract

Objective: To compare the survival benefit and safety profiles between lenvatinib and donafenib when used as conversion therapies for patients with hepatocellular carcinoma (HCC) at the China National Liver Cancer (CNLC) stages I-III.

Methods: A retrospective comparative study was conducted on 76 patients diagnosed with HCC at CNLC stage I-III. Among them, 40 patients were treated with lenvatinib, and the other 36 patients received donafenib. Key outcomes, including overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse events, were evaluated.

Results: Patients treated with lenvatinib showed significantly longer OS (14.9 vs. 7.9 months, P=0.010) and PFS (4.6 vs. 2.9 months, P<0.001) compared to those treated with donafenib. The ORR was 15% in the lenvatinib group and 5.6% in the donafenib group (P=0.551). Lenvatinib was also associated with a lower incidence of grade ≥3 adverse events (P<0.05). Specifically, severe adverse events such as hepatotoxicity, hematological toxicity, hand-foot syndrome, and diarrhea were less frequent in the lenvatinib cohort. Univariate and multivariate analyses identified elevated alpha-fetoprotein (AFP) levels and the presence of hepatic vein tumor thrombus as significant predictors of poorer PFS, with hazard ratios (HR) of 1.45 and 1.80, respectively. Furthermore, multivariate analysis revealed that higher Child-Pugh scores and elevated AFP levels were associated with worse OS (all P<0.05).

Conclusion: Lenvatinib demonstrates superior survival outcomes compared to donafenib as a conversion therapy in patients with CNLC stage I-III HCC. While the two therapies are comparable in overall safety profiles, lenvatinib is more tolerated, with a lower incidence of severe adverse events.

Keywords: Hepatocellular carcinoma; conversion therapy; donafenib; lenvatinib; survival benefit.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Kaplan-Meier curves of median progression-free survival between two groups (Time-month). PFS: progression-free survival.
Figure 2
Figure 2
Kaplan-Meier curves of median overall survival between two groups (Time-month).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ganesan P, Kulik LM. Hepatocellular carcinoma: new developments. Clin Liver Dis. 2023;27:85–102. - PubMed
    1. Wang L, Zhu L, Liang C, Huang X, Liu Z, Huo J, Zhang Y, Zhang Y, Chen L, Xu H, Li X, Xu L, Kuang M, Wong CC, Yu J. Targeting N6-methyladenosine reader YTHDF1 with siRNA boosts antitumor immunity in NASH-HCC by inhibiting EZH2-IL-6 axis. J Hepatol. 2023;79:1185–1200. - PubMed
    1. Wang Y, Deng B. Hepatocellular carcinoma: molecular mechanism, targeted therapy, and biomarkers. Cancer Metastasis Rev. 2023;42:629–652. - PubMed
    1. Liu T, Guo Y, Liao Y, Liu J. Mechanism-guided fine-tuned microbiome potentiates anti-tumor immunity in HCC. Front Immunol. 2023;14:1333864. - PMC - PubMed
    1. Alawyia B, Constantinou C. Hepatocellular carcinoma: a narrative review on current knowledge and future prospects. Curr Treat Options Oncol. 2023;24:711–724. - PubMed

LinkOut - more resources